Carolyn Edlund, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA9107110 Issued in FL

Practice address

699 S Indiana Ave
Englewood, FL 34223-3705

Phone

(941) 474-8811

NPI assigned

Feb 25, 2013

Last updated

Aug 5, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Dermatology, LLCGroup PAC ID 6002031531, 48 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Premier Dermatology, LLC

  • Dermatology Physician
  • Sarasota, FL
  • NPI 1700202298
  Medicare reassignment Care Compare group
• Michelle Pennie MD LLC

  • Dermatology Physician
  • Englewood, FL
  • NPI 1558620385
  NPD (past)
• Riverview Cardiac Surgery PA

  dba Riverview Cardiac Surgery

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Bradenton, FL
  • NPI 1922053115
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1361750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1013257385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 NIRA ST",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078652",
            "telephone_number": "904-387-4991",
            "fax_number": "904-384-3613"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 S INDIANA AVE",
            "city": "ENGLEWOOD",
            "state": "FL",
            "postal_code": "342233705",
            "telephone_number": "941-474-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDLUND",
        "first_name": "CAROLYN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-25",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107110",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "FL",
            "license": "PA9107110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keri L Duff
• Edward George Dumas, LCSW
• Sharon Taylor Dunbar, LCSW
• Jessica Durand, PHARMACIST INTERN
• Megan M Earles, MSW, LCSW
• Edward Fetherolf M D P a
• Ehra Medical Services of Florida LLC
• Andrew Cole Eisenberg, MD
• Ekiong C. Tan M.D., P.a.
• Elite Cardiology Care, LLC

• Surgical Physician Assistant in Englewood, FL
• Providers in Englewood, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.